Is there a segment of the medical world where no fraudulent activity ever takes place? The sad reality is that there isn’t. Over the past three years, in researching for the Allegiant Experts Blog, we’ve encountered stories that prove the health care fraud knows no bounds. Earlier this week, a Detroit, Michigan-area podiatrist and a Columbus, Ohio-based pharmacist further evidenced this fact.
Lawrence Young was sentenced to 28 months in prison.
The 70 year-old foot doctor was handed a 28 month prison term for his role in a $1 million scheme to defraud Medicare. According to a United States Department of Justice report released this past Tuesday, Young billed Medicare for podiatry services that were never rendered. In addition to imprisonment, the Bloomfield, Michigan resident is also required to serve one year of supervised release and pay $337,907.31 in restitution to The United States Department of Health and Human Services (HHS). He must also forfeit the same amount.
Young’s sentencing brings to a close a trial that was completed in January of this year when he pleaded guilty to health care fraud. He admitted that from approximately January 2010 through April 2017, he engaged in a scheme to defraud the Medicare program. According to the DOJ report, the scheme involved the submission of false and fraudulent claims to Medicare for the application of an “Unna Boot”.
An “Unna Boot” is a type of medicated dressing which is typically applied after surgery. Its purpose is to control the swelling of the leg or foot. “Young admitted regularly submitting these claims for reimbursement even though he knew that his patients routinely received nothing more than a non-medicated dressing,” reads the report, “The scheme involved the submission of more $1 million in fraudulent claims to Medicare, he admitted. “
Maria Mascio was sentenced to 24 months in prison.
Also this past Tuesday, the Southern District of Ohio branch of the United States Department of Justice reported the sentencing of a Columbus-based pharmacist. 62 year-old, Maria Mascio was handed down a 24 month prison sentence and ordered to pay $1.1 million in restitution for her role in a health care fraud scheme that spanned an entire decade.
Mascio was a licensed pharmacist and owner of Family Medical Pharmacy and Visions Systems in Columbus, Ohio. According to the report, between 2003 and 2013, she “schemed to defraud Medicare, Ohio Medicaid, Ohio Bureau of Workers’ Compensation and private insurers by billing for sample drugs that could not be legally sold and for medications that had not been dispensed.”
Mascio was the owner of the office building where her pharmacy was located. The building also housed the medical offices of two doctors. She directed her employees to take prescription drug samples from the medical offices and place them in a storage room that was being used by the pharmacy. The drugs were later removed from their individualized packaging and stored in plastic bins.
“They disposed of the sample packaging in the dumpster located on the premises of the pharmacy and placed the sample drugs into the pharmacy inventory where they were co-mingled with the pharmacy’s stocked drugs and dispensed to the general public,” the report details. This past May, Mascio pleaded guilty to one count of health care fraud and one count of conspiracy to commit an offense against the United States.
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